A: The book? The book is great. I think it’s generally accurate and will probably help many people. But before we talk about food, let’s talk about feces!

I know, your favorite. But really. You are crawling with more bacteria, particularly in your gut, than you have human cells in your body. You are the known universe for billions of generations of bacteria, yeasts, and other interesting critters. Thus the fascinating medical technology of the fecal transplant. In this medical procedure the patient is cleaned out of stuff existing in the colon and this is replaced with donor poop. The technique is used for several medical conditions but there’s been growing interest in using fecal transplants for weight loss.

Think about what this means. This means that an obese person can be cleaned out and have their intestinal micro universe replaced with the biome of a thin person with a high metabolism and begin to see weight loss results. We can, and may, debate about why this works but the point is that when your ancestors traveled to the USA or wherever you’re reading this they brought more than their funny clothes, language, and DNA. They also brought a caravan of microbes that, through kisses, spit washes on faces, dietary habits, and accidental infections (people walk by me while I’m scouring my shopping cart down despite the fact that 72% or more have fecal matter on them) have passed these microscopic plants and animals on to you. You are carrying around the descendants of bacteria that were hovering near the appendix of your great grandmother.

In short, when anyone says there is a universal health statistic or diet plan they are basically starting with a bullshit premise because there’s more going on in your body than some consistent and predictable reactions. Even pharmaceuticals should be diversified because something as basic as gender differences can cause them to work differently.

Fuhrman’s book is filled with good general advice and some creaky ideas as well. There is also a bias or two about other non-Fuhrman-designed health plans.

The good ideas are that foods that come from the ground are generally better for you than other foods. Fuhrman specifies this by stating that there should be a preference in the diet for “nutritionally dense” foods. For example, broccoli is low in calories and carbohydrates but rich in phytonutrients, macronutrients, and protein. Green leafy vegetables (except for iceberg lettuce, it’s basically green water) are reliably good sources of a wide range of nutritious things that are good for you. Want to know who else says this? The Atkins Diet, the Mediterranean Diet, and (gasp) the Ketogenic diet. Basically you can’t go wrong on having a head of romaine lettuce for lunch on nearly any diet.

Where the diets part ways is on the specific impact of fats and animal proteins when taken in isolation from other foods. Fuhrman’s book has excellent documentation, as these books often do. Even health and diet books that others in the field of the author will later tell you are certain death lurking on a plate document their claims. Where the fork meets the plate is interpretation. We’re not talking a peer reviewed paper we’re talking about popular diet/nutrition books. The problem with almost every health study relating to food is that it relies on self-documentation by the participants. In a perfect world a study could be done with, say, voluntary prison populations in which isolated but racially-mixed groups could be put on a specific diet regime with a control population and tested weekly for changes in blood chemistry, urinalysis, and maybe even stool samples to find out what exactly happens when someone goes on a specific diet plan.

Most modern diet plans rightfully work to restrict sweetened items, whether the sweetener is fructose, sucrose, or high-fructose corn syrup. I’ll do another posting on some of the whys. If I have any gripe about Fuhrman’s plan it’s his reliance on fruit as a nutrient source. Sugar is sugar, whether it’s grown in a plant or produced in a beehive or clipped from a starch by enzymes after eating.

Cutting animal proteins is not a big issue on any of the diets. Fuhrman restricts them more than most and that’s fine. There are a lot of modern thinkers, including philosopher Peter Singer, who believe meat is unethical, principally because producing it has a high carbon footprint. The Ketogenic diet keeps proteins of any kind to 20% of caloric intake, but there’s no restriction on where it comes from as long as carbohydrate levels are kept below 5% of calories. When I did Atkins (with good results) in my 40s I was always surprised by opposing views of the plan that didn’t describe what the plan really called for accurately. It’s like arguing religion with people who really don’t know what religion is about and have never read past a few chapters of Genesis.

I’m sure for most of the people who take Fuhrman’s approach there will be beneficial effects. Fuhrman, as far as I can tell, has never done a blind research study on his diet. He’s a doctor recommending eating plans to his patients based on his reading and has gotten a great deal of positive feedback from those patients.

My own plan is that I may see how it does for me if the Ketogenic, in which I’ve invested some time and work into getting into and maintaining ketosis, does not help. I’m due for a physical in June and have enough history with this doctor to compare several years of fasting blood tests. Meanwhile my crisper is filled with baby spinach, raw broccoli, kale, and hearts of romaine to go along with the high fat moderate protein Ketogenic diet.

By all means get and follow this book’s advice if it’s an attractive or reasonable option for you. Diets should meet certain criteria:

It works

It works without doing harm

It’s adaptable to your culture, body type, and preferences

It’s portable so you can follow it even traveling to foreign countries with maybe a few things in your bag to help

It doesn’t break your budget to follow

You can maintain it comfortably for life

Eat to Live does most of this well and anyone squeamish about other diet plans as being too extreme should check this out.